Provider Demographics
NPI:1538381223
Name:SINGLE, JASON ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ANDREW
Last Name:SINGLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BUFORD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3363
Mailing Address - Country:US
Mailing Address - Phone:864-224-2325
Mailing Address - Fax:864-224-8497
Practice Address - Street 1:102 BUFORD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3363
Practice Address - Country:US
Practice Address - Phone:864-224-2325
Practice Address - Fax:864-224-8497
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist